Accuracy of determining cardiac arrest by emergency medical dispatchers

Ann Emerg Med. 1994 May;23(5):1022-6. doi: 10.1016/s0196-0644(94)70097-4.

Abstract

Study objective: To identify and determine the rates of delivery and performance of telephone CPR in noncardiac arrest incidents.

Design: We studied prospectively all out-of-hospital cardiac arrest and potential cardiac arrest incidents from July 1 through October 31, 1992.

Setting: King County, Washington, excluding the city of Seattle.

Participants: Persons with cardiac arrest or an initial complaint resembling cardiac arrest who received emergency medical services.

Interventions: Dispatcher-assisted telephone CPR.

Measurements and main results: Three hundred fifty-eight incidents of cardiac arrest, respiratory arrest, and potential cardiac arrest were reviewed. Telephone CPR was offered appropriately in 61 of 87 cases (70%) and inappropriately in eight of 154 potential cardiac arrests (5.2%) (95% confidence interval, 1.7%, 8.7%). Ventilation instructions were performed appropriately in 52 of 87 cases (60%) and inappropriately in three of 154 potential cardiac arrests (1.9%) (95% confidence interval, 0%, 4.1%). Chest compressions were performed appropriately in 26 of 68 cardiac arrests (38.2%) and inappropriately in two of 173 potential cardiac arrests (1.2%) (95% confidence interval, 0%, 2.8%).

Conclusion: We found a low rate of performance of telephone CPR in King County for incidents resembling cardiac arrest. This finding suggests that the protocols designed for dispatcher-assisted telephone CPR effectively screen out those incidents that may initially resemble cardiac arrest.

MeSH terms

  • Adult
  • Aged
  • Cardiopulmonary Resuscitation / education*
  • Cardiopulmonary Resuscitation / methods
  • Child
  • Clinical Protocols
  • Confidence Intervals
  • Emergency Medical Service Communication Systems*
  • Emergency Medical Services / standards*
  • Female
  • First Aid
  • Heart Arrest / diagnosis*
  • Heart Arrest / epidemiology
  • Heart Arrest / therapy
  • Humans
  • Male
  • Prospective Studies
  • Washington